Prevalence, Predictors, and Consequences of Alcohol Use from Childhood to Midlife

描述（由申请人提供）：基于生命历程发展的视角，本申请建议使用三个正在进行的具有全国代表性的出生队列研究（2001年、1970年、1958年出生，每组1万名）的主要和次要纵向数据来检查从青春期早期到中年饮酒的患病率、预测因素和后果。这种发展流行病学应用的具体目的是：(1)从2001年千禧年队列研究（MCS）的11岁调查开始，开展第一个关于早期酒精使用和态度的前瞻性国家研究，检验早期酒精开始流行的变化，并使用结构方程模型检验MCS和1970年英国队列研究（BCS）中关于儿童气质、认知和家庭对早期酒精使用影响的理论假设；(2)在BCS和1958年全国儿童发展研究（NCDS）中，使用固定效应模型控制稳定的未观察到的效应，研究成年期工作、家庭和公民社会角色的变化如何预测酒精使用和问题饮酒的波动（角色社会化假说）；(3)使用倾向评分模型记录酒精使用对中年（BCS/NCDS中38/50岁）健康和社会角色的长期影响。假设轻度至中度饮酒（相对于戒酒和酗酒）预示着更大的中年健康和角色成功（后果假设）。针对所有目标的分析将使用多来源——父母、教师、医疗、认知、自我报告和多波纵向数据来控制儿童和青少年的社会和个人资本（选择假设），并检验观察到的影响是否对那些拥有更大资本的人起到缓冲作用（选择x角色社会化，选择x后果假设）。要求资金在11岁MCS调查中增加终身酒精起始、使用频率和酗酒、最大数量、积极和消极酒精预期、感知风险和感知同伴压力等措施，并使用已经收集的从出生到7岁（MCS）、38岁（BCS）和50岁（非传染性疾病）的纵向数据进行二次数据分析。从长期来看，该项目旨在跟踪MCS群体到青春期及以后，跟踪BCS和非传染性疾病群体到老年（随着关键社会角色的不断变化和酒精使用/滥用后果的积累），以记录人口和亚人口模式、影响以及对重度饮酒和问题饮酒的脆弱性的变化。关于整个生命过程中饮酒模式的前瞻性国家数据，并对潜在的虚假风险和保护因素以及有条件的影响进行适当控制，对于以下方面至关重要：(a)确定脆弱性的发育前因，(b)了解机制并排除虚假影响，以及(c)为减少酒精滥用和依赖的危害（包括疾病）提供和调整适合发展的方案和公共卫生建议，伤害，以及社会角色问题。

DESCRIPTION (provided by applicant): Based on a life course developmental perspective, this application proposes to use primary and secondary longitudinal data from three ongoing nationally representative birth cohort studies (born 2001, 1970, 1958; each n >10,000) to examine prevalence, predictors, and consequences of alcohol use from early adolescence through midlife. Specific aims of this developmental epidemiological application are to: (1) Examine variation in the prevalence of early alcohol initiation by conducting the first prospective national study of early alcohol use and attitudes starting in the age 11 survey of the 2001 Millennium Cohort Study (MCS), and testing theory- based hypotheses about child temperamental, cognitive, and family influences on early alcohol use in the MCS and the 1970 British Cohort Study (BCS) with structural equation models; (2) In the BCS and 1958 National Child Development Study (NCDS), examine how changes in work, family, and civic social roles across adulthood predict fluctuations in alcohol use and problem drinking (Role Socialization hypothesis), using fixed effects models to control for stable unobserved effects; and (3) Document long-term consequences of alcohol use for health and social roles in midlife (age 38/50 in BCS/NCDS) using propensity score models. J-shaped associations are hypothesized in which light-to-moderate alcohol use (relative to abstaining and to heavy drinking) predicts greater midlife health and role success (Consequences hypothesis). Analyses addressing all aims will use multisource-parent, teacher, medical, cognitive, self- report-and multi-wave longitudinal data to control for child and adolescent social and personal capital (Selection hypothesis) and test whether observed effects are buffered for those with greater capital (Selection x Role Socialization, Selection x Consequences hypotheses). Funds are requested to add measures of lifetime alcohol initiation, frequency of use and binge drinking, maximum quantity, positive and negative alcohol expectancies, perceived risk, and perceived peer pressure to age 11 MCS surveys, and to conduct secondary data analyses using already- collected longitudinal data from birth to age 7 (MCS), age 38 (BCS), and age 50 (NCDS). Long- term, the project aims to follow the MCS cohort through adolescence and beyond and the BCS and NCDS cohorts into older adulthood (as pivotal social roles continue to change and alcohol use/abuse consequences accumulate) to document population and sub-population patterns, effects, and variation in vulnerability to heavy and problem drinking. Prospective national data on drinking patterns across the life course, with appropriate controls for potentially spurious risk and protective factors and for conditional effects, are vital for (a) identifying developmental antecedents of vulnerability, (b) understanding mechanisms and ruling out spurious effects, and (c) informing and tailoring developmentally-appropriate programs and public health recommendations designed to decrease harms of alcohol abuse and dependence including disease, injury, and social role problems. PUBLIC HEALTH RELEVANCE: The project will provide new and needed knowledge about the prevalence and developmental antecedents of early adolescent alcohol use and attitudes favorable and unfavorable to use, as well as about the long-term consequences of heavy alcohol use and problems in early to middle adulthood. Based on a developmental epidemiological approach, the project combines the advantages of large scale prospective representative longitudinal survey research with the strengths of cutting-edge longitudinal methods for estimating the determinants and consequences of alcohol use across the life course. The work will lead to better targeting of populations, age groups, and risk and protective factors in preventions aimed at delaying onset, reducing underage drinking, and reducing alcohol abuse and dependence in adulthood.